Kinetic and Crystallographic Studies of Drug-Resistant Mutants of HIV-1 Protease: Insights into the Drug Resistance Mechanisms

HIV-1 protease (PR) inhibitors (PIs) are important anti-HIV drugs for the treatment of AIDS and have shown great success in reducing mortality and prolonging the life of HIV-infected individuals. However, the rapid development of drug resistance is one of the major factors causing the reduced effectiveness of PIs. Consequently, various drug resistant mutants of HIV-1 PR have been extensively studied to gain insight into the mechanisms of drug resistance. In this study, the crystal structures, dimer stabilities, and kinetics data have been analyzed for wild type PR and over 10 resistant mutants including PRL24I, PRI32V, PRM46L, PRG48V, PRI50V, PRF53L, PRI54V, PRI54M, PRG73S and PRL90M. These mutations lie in varied structural regions of PR: adjacent to the active site, in the inhibitor binding site, the flap or at protein surface. The enzymatic activity and inhibition were altered in mutant PR to various degrees. Crystal structures of the mutants complexed with a substrate analog inhibitor or drugs indinavir, saquinavir and darunavir were determined at resolutions of 0.84 – 1.50 Å. Each mutant revealed distinct structural changes, which are usually located at the mutated residue, the flap and inhibitor binding sites. Moreover, darunavir was shown to bind to PR at a new site on the flap surface in PRI32V and PRM46L. The existence of this additional inhibitor binding site may explain the high effectiveness of darunavir on drug resistant mutants. Moreover, the unliganded structure PRF53L had a wider separation at the tips of the flaps than in unliganded wild type PR. The absence of flap interactions in PRF53L suggests a novel mechanism for drug resistance. Therefore, this study enhanced our understanding of the role of individual residues in the development of drug resistance and the structural basis of drug resistance mechanisms. Atomic resolution crystal structures are valuable for the design of more potent protease inhibitors to overcome the drug resistance problem

Resilience to resistance of HIV-1 protease inhibitors: profile of darunavir

The current effectiveness of HAART in the management of HIV infection is compromised by the emergence of extensively cross-resistant strains of HIV-1, requiring a significant need for new therapeutic agents. Due to its crucial role in viral maturation and therefore HIV-1 replication and infectivity, the HIV-1 protease continues to be a major development target for antiretroviral therapy. However, new protease inhibitors must have higher thresholds to the development of resistance and cross-resistance. Research has demonstrated that the binding characteristics between a protease inhibitor and the active site of the HIV-1 protease are key factors in the development of resistance. More specifically, the way in which a protease inhibitor fits within the substrate consensus volume, or substrate envelope , appears to be critical. The currently available inhibitors are not only smaller than the native substrates, but also have a different shape. This difference in shape underlies observed patterns of resistance because primary drug-resistant mutations often arise at positions in the protease where the inhibitors protrude beyond the substrate envelope but are still in contact with the enzyme. Since all currently available protease inhibitors occupy a similar space (in spite of their structural differences) in the active site of the enzyme, the specific positions where the inhibitors protrude and contact the enzyme correspond to the locations where most mutations occur that give rise to multidrug-resistant HIV-1 strains. Detailed investigation of the structure, thermodynamics, and dynamics of the active site of the protease enzyme is enabling the identification of new protease inhibitors that more closely fit within the substrate envelope and therefore decrease the risk of drug resistance developing. The features of darunavir, the latest FDA-approved protease inhibitor, include its high binding affinity (Kd = 4.5 x 10-12 M) for the protease active site, the presence of hydrogen bonds with the backbone, and its ability to fit closely within the substrate envelope (or consensus volume). Darunavir is potent against both wild-type and protease inhibitor-resistant viruses in vitro, including a broad range of over 4,000 clinical isolates. Additionally, in vitro selection studies with wild-type HIV-1 strains have shown that resistance to darunavir develops much more slowly and is more difficult to generate than for existing protease inhibitors. Clinical studies have shown that darunavir administered with low-dose ritonavir (darunavir/ritonavir) provides highly potent viral suppression (including significant decreases in HIV viral load in patients with documented protease inhibitor resistance) together with favorable tolerability. In conclusion, as a result of its high binding affinity for and overall fit within the active site of HIV-1 protease, darunavir has a higher genetic barrier to the development of resistance and better clinical efficacy against multidrug-resistant HIV relative to current protease inhibitors. The observed efficacy, safety and tolerability of darunavir in highly treatment-experienced patients makes darunavir an important new therapeutic option for HIV-infected patients

Molecular Basis for Drug Resistance in HIV-1 Protease

HIV-1 protease is one of the major antiviral targets in the treatment of patients infected with HIV-1. The nine FDA approved HIV-1 protease inhibitors were developed with extensive use of structure-based drug design, thus the atomic details of how the inhibitors bind are well characterized. From this structural understanding the molecular basis for drug resistance in HIV-1 protease can be elucidated. Selected mutations in response to therapy and diversity between clades in HIV-1 protease have altered the shape of the active site, potentially altered the dynamics and even altered the sequence of the cleavage sites in the Gag polyprotein. All of these interdependent changes act in synergy to confer drug resistance while simultaneously maintaining the fitness of the virus. New strategies, such as incorporation of the substrate envelope constraint to design robust inhibitors that incorporate details of HIV-1 protease’s function and decrease the probability of drug resistance, are necessary to continue to effectively target this key protein in HIV-1 life cycle

Crystallographic Analysis and Kinetic Studies of HIV-1 Protease and Drug-Resistant Mutants

HIV-1 protease is the most effective target for drugs to treat AIDS, however, the long-term therapeutic efficiency is restricted by the rapid development of drug resistant variants. To better understand the molecular basis of drug resistance, crystallographic and kinetic studies were applied to wild-type HIV-1 protease (PR) and drug-resistant mutants, PRV82A, and PRI84V, in complex with substrate analogues, the current drug saquinavir and the new inhibitor UIC-94017 (TMC-114). UIC-94017 was also studied with mutants PRD30N and PRI50V. The drug-resistant mutations V82A, I84V, D30N and I50V participate in substrate binding. Eighteen crystal structures were refined at resolutions of 0.97-1.60A. The high accuracy of the atomic resolution crystal structures helps understand the reaction mechanism of HIV-1 PR. Different binding modes are observed for different types of inhibitors. The substrate analogs have more extended interactions with PR subsites up to S5-S5\u27, while the clinical inhibitors maximize the contacts within S2-S2\u27. Hydrophobic interactions are the major force for saquinavir binding since it was designed with enhanced hydrophobic groups based on substrate side-chains. In contrast, the new clinical inhibitor UIC-94017 was designed to mimic the hydrogen bonds between substrates and PR. UIC-94017 forms polar interactions with the PR main-chain atoms of Asp29/30, which have been proposed to be critical for its potency against resistant HIV. The mutants showed different structural and kinetic effects, depending on the inhibitor and location of the mutations. The observed structural changes were consistent with the relative inhibition data. Both PRI84V and PRI50V lost favorable hydrophobic interactions with inhibitor compared with PR. Similarly, in PRD30N the UIC-94017 had a water-mediated interaction with the side-chain of Asn30 rather than the direct interaction observed in PR. However, PRV82A compensated for the mutation by shifts of the backbone of Ala82. Furthermore, the complexes of PRV82A showed smaller shifts relative to PR, but more movement of the peptide analog, compared to complexes with clinical inhibitors. The structures suggest that substrate analogs have more flexibility than the drugs to accommodate the structural changes caused by mutation, which may explain how HIV can develop drug resistance while retaining the ability of PR to hydrolyze natural substrates

HIV-1 Protease: Structural Perspectives on Drug Resistance

Antiviral inhibitors of HIV-1 protease are a notable success of structure-based drug design and have dramatically improved AIDS therapy. Analysis of the structures and activities of drug resistant protease variants has revealed novel molecular mechanisms of drug resistance and guided the design of tight-binding inhibitors for resistant variants. The plethora of structures reveals distinct molecular mechanisms associated with resistance: mutations that alter the protease interactions with inhibitors or substrates; mutations that alter dimer stability; and distal mutations that transmit changes to the active site. These insights will inform the continuing design of novel antiviral inhibitors targeting resistant strains of HIV

Structures of Darunavir-Resistant HIV‑1 Protease Mutant Reveal Atypical Binding of Darunavir to Wide Open Flaps

The molecular basis for high resistance to clinical inhibitors of HIV-1 protease (PR) was examined for the variant designated PRP51 that was selected for resistance to darunavir (DRV). High resolution crystal structures of PRP51 with the active site D25N mutation revealed a ligand-free form and an inhibitor-bound form showing a unique binding site and orientation for DRV. This inactivating mutation is known to increase the dimer dissociation constant and decrease DRV affinity of PR. The PRP51‑D25N dimers were in the open conformation with widely separated flaps, as reported for other highly resistant variants. PRP51‑D25N dimer bound two DRV molecules and showed larger separation of 8.7 Å between the closest atoms of the two flaps compared with 4.4 Å for the ligand-free structure of this mutant. The ligand-free structure, however, lacked van der Waals contacts between Ile50 and Pro81′ from the other subunit in the dimer, unlike the majority of PR structures. DRV is bound inside the active site cavity; however, the inhibitor is oriented almost perpendicular to its typical position and exhibits only 2 direct hydrogen bond and two water-mediated interactions with atoms of PRP51‑D25N compared with 11 hydrogen bond interactions seen for DRV bound in the typical position in wild-type enzyme. The atypical location of DRV may provide opportunities for design of novel inhibitors targeting the open conformation of PR drug-resistant mutants

Molecular dynamics study of HIV-1 protease inhibitors and their effects on the flap dynamics of the HIV-1 subtype-C (C-SA).

Masters Degree. University of KwaZulu-Natal, Durban.The aspartyl protease human immunodeficiency virus type 1 (HIV-1) is a 99-amino acid-long homodimer responsible for processing the Gag and Gag-Pol polyproteins into functional constituent proteins necessary for development of infectious HIV particles. Of global infections recorded, subSaharan African region is represented by 56 % where nearly 25 million people are living with HIV. South Africa has been shown to carry the heaviest HIV burden in sub-Saharan Africa where the HIV-1 subtype C (C-SA) is the prominent strain. Most of the HIV-1 scientific research has been done specifically for subtype B and this has been highlighted by the weaker binding affinity displayed by the South African HIV-1 subtype C for most of the clinically approved protease inhibitors when compared to the HIV-1 subtype B protease. The two flaps of the HIV-1 PR are very essential in functioning of the enzyme as their conformations control entry of the substrate into the catalytic site of the enzyme and also to release product. It is very important to explore and understand the dynamics of these flaps in binding of different inhibitors with different binding affinities. In addition, studies have highlighted the focus on inhibiting the cleaving function of HIV-1 PR with protease inhibitors (PIs) by competing with the natural substrate for the enzyme’s active or catalytic site and thus rendering its ineffective. It has been shown that in addition to the active site, more regions of the enzyme can be possible targets for inhibition process by developing drugs that can hinder the opening of the flaps or disrupt the stability of the dimer interface. This study involved the use of computational techniques to explore the major contributing factors other than interactions with the binding site, in binding affinity of FDA approved second generation PIs complexed to HIV-1 C-SA PR. In pursuance of this objective, molecular dynamics simulations, binding-free energy calculations and dynamic analyses were utilized. Several distances, different angles between certain residues were all taken into consideration. Our findings do show that apart from binding free-energy calculations, not one single factor but several factors contribute to the binding affinity of protease inhibitors. It is clear from these results that in the development of new HIV-1 drugs, more emphasis should be made in the design of drugs with, not only better binding in the active site but also with better interaction with other regions of the enzyme. Another interesting emphasis drawn from this study is that there is still need for drug development targeting HIV-1 PR C-SA as the currently available drugs were modelled around the inhibition of HIV-1 subtype B

Substrate Envelope-Based Design of New Dipeptide Isostere Cores for the Development of Protease Inhibitors against Drug-Resistant HIV-1

Drug resistance is one of the major causes for HIV-infected patients to lose lives. An innovative HIV-1 protease inhibitor scaffold needs to be developed to resolve drug resistance issues. During this investigation, HIV-1 protease inhibitors based on a novel keto-hydroxyethylene core were designed and synthesized based on the substrate envelope theory. This core targets to overcome drug resistance to Amprenavir and Darunavir caused by I50V mutation in the protease. The results of florescence resonance energy transfer (FRET) assays indicate that the new inhibitor has moderate enzymatic inhibitory activities against HIV-1 protease. In the future, a variety of drug analogues will be developed based on this new core structure and might provide better therapies against drug-resistant HIV-1

Mechanismus působení nepeptidových inhibitorů HIV proteasy

Inhibice HIV-1 proteasy hraje významnou roli v boji proti viru HIV. Od roku 1995 bylo na trh uvedeno devět inhibitorů HIV-1 proteasy, avšak jejich účinnost klesá vinou vzniku rezistence viru vůči inhibitorům. Proto je potřeba vyvíjet účinnější léčiva s novými strukturními motivy a mechanismy účinku. V nedávné době byla u několika inhibitorů pozorována jejich vazba i mimo aktivní místo proteasy. Darunavir, jenž je posledním schváleným inhibitorem HIV-1 proteasy a vykazuje kompetitivní typ inhibice, se pravděpodobně také váže do oblasti chlopní HIV-1 proteasy. Dvě studie podporující tento alternativní způsob vazby byly založeny na kinetických měřeních a rentgenové krystalografii. Je však otázkou, zda-li dochází k této vazbě i za fyziologických podmínek anebo zda-li se jedná pouze o krystalizační artefakt. I další data podporují alternativní vazbu darunaviru s vysoce mutovanou HIV-1 proteasou: pomocí termodynamické analýzy bylo prokázano, že na dimerní HIV-1 proteasu se váží dvě molekuly darunaviru. Nicméně toto pozorování nebylo potvrzeno rentgenovou krystalografií, neboť darunavir byl v krystalové struktuře přítomen pouze v aktivním místě HIV-1 proteasy. Tato vysoce mutovaná varianta HIV-1 proteasy se proto stala předmětem dalšího zkoumání. Pro studium mechanismu vazby darunaviru na mutovanou...The inhibition of HIV-1 protease plays an important role in combating HIV. Nine HIV-1 protease inhibitors have been succesfully marketed for the treatment since 1995. However, their efficiencies decrease due to the resistance development. More potent compounds with novel structural motifs and mechanisms of action are therefore still needed. Several inhibitory compounds have been reported to bind to the protease at the loci different from the active site. Interestingly, darunavir, which is the last approved inhibitor with supposedly competitive mode of action, was also suggested to bind to the flap region of the protease. Two studies discussed this alternative binding mode based on the X-ray structural and kinetic analysis, respectively. Nevertheless, it is questionable, if such a mechanism is relevant also in physiological conditions or if it is only an artifact of crystallization. Another study provided a strong evidence for the alternative binding of darunavir to highly mutated HIV-1 protease. Based on thermodynamic analysis, it was shown that two molecules of darunavir bind to the protease dimer. Surprisingly, this observation was not confirmed by the X-ray structure analysis since the inhibitor was bound only within the active site. However, this protease variant was employed in further...Katedra biochemieDepartment of BiochemistryPřírodovědecká fakultaFaculty of Scienc